Category: PPACA

Expansion of Mental Health Care Hits Obstacles – NYTimes.com

 

LOUISVILLE, Ky. — Terri Hall’s anxiety was back, making her hands shake as she tried to light a cigarette on the stoop of her faded apartment building. She had no appetite, and her mind galloped as she grasped for an answer to her latest setback.

In January, almost immediately after she got Medicaid coverage through the Affordable Care Act, she had called a community mental health agency seeking help for the depression and anxiety that had so often consumed her.

Now she was getting therapy for the first time, and it was helping, no question. She just wished she could go more often. The agency, Seven Counties Services, has been deluged with new Medicaid recipients, and Ms. Hall has had to wait up to seven weeks between appointments with her therapist, Erin Riedel, whose caseload has more than doubled.

“She’s just awesome,” Ms. Hall said. “But she’s busy, very busy.”

The Affordable Care Act has paved the way for a vast expansion of mental health coverage in America, providing access for millions of people who were previously uninsured or whose policies did not include such coverage before. Under the law, mental health treatment is an “essential” benefit that must be covered by Medicaid and every private plan sold through the new online insurance marketplaces.

Expansion of Mental Health Care Hits Obstacles – NYTimes.com

Insurers Once on the Fence Plan to Join Health Exchanges in ’15 – NYTimes.com

 

In a sign of the growing potential under the federal health care law, several insurers that have been sitting on the sidelines say they will sell policies on the new exchanges in the coming year, and others plan to expand their offerings to more states.

“Insurers continue to see this as a good business opportunity,” said Larry Levitt, a health policy expert at the Kaiser Family Foundation. “They see it as an attractive market, with enrollment expected to ramp up in the second year.” Eight million people have signed up for coverage in 2014, and estimates put next year’s enrollment around 13 million.

In New Hampshire, for example, where Anthem Blue Cross is the only insurer offering individual coverage on the state exchange, two other plans, both from Massachusetts, say they intend to offer policies next year. Harvard Pilgrim Health Care, a nonprofit insurer with 1.2 million members, said it expected to participate in the exchanges in both New Hampshire and Maine for the first time and to add Connecticut to the mix in 2016.

Insurers Once on the Fence Plan to Join Health Exchanges in ’15 – NYTimes.com

Geisinger Health Plan enrolls more than 20,000 through Obamacare – themorningcall.com

 

Geisinger Health Plan, a health insurance company serving Lehigh, Northampton and 39 other Pennsylvania counties, added more than 20,000 members during the first open-enrollment period under the federal Affordable Care Act, the company announced Monday.

"We are extremely happy with the number of individuals who selected Geisinger Health Plan for their health insurance coverage," says David Brady, vice president of health care reform and commercial business development. "We felt it was important to offer individuals who were shopping on the marketplace a choice of coverage options that focused on quality and customer service. Based on our results, Pennsylvanians agreed."

Geisinger Health Plan offered 26 plans on the federal marketplace and GeisingerMarketplace.com, its private site, the company said in a statement.

Geisinger Health Plan enrolls more than 20,000 through Obamacare – themorningcall.com

Cabbies Hail For Health Insurance | NBC 10 Philadelphia

Getting health insurance in spite of Gov. Corbett!

About 80 percent of the nearly 5,000 taxi drivers in the city did not have insurance prior to the Affordable Care Act going into effect, said Ronald Blount, president of the Unified Taxi Workers Alliance of Pennsylvania.

"They were pretty much on their own," he said. "If a driver was hit by a drunk driver, the taxi auto insurance doesn’t cover the driver.”

"They’d be stuck with big medical bills,” added Blount, who said many drivers are plagued by “silent killers” like diabetes, high blood pressure and high cholesterol since many eat while on the go and are sitting for most of the day.

In an effort to enroll as many cabbies as possible, the TWA teamed up with two nonprofits focused on health care, Healthy Philadelphia and Get Covered America, to hold regular enrollment and information sessions.

Cabbies Hail For Health Insurance | NBC 10 Philadelphia

Rooting for Failure – NYTimes.com

 

It’s hard to remember a time when a major political party and its media arm were so actively rooting for fellow Americans to lose. When the first attempt by the United States to launch a satellite into orbit, in 1957, ended in disaster, did Democrats start to cheer, and unify to stop a space program in its infancy? Or, when Medicare got off to a confusing start, did Republicans of the mid-1960s wrap their entire political future around a campaign to deny government-run health care to the elderly?

Of course not. But for the entity of the Obama era, Republicans have consistently been cheerleaders for failure. They rooted for the economic recovery to sputter, for gas prices to spike, the job market to crater, the rescue of the American automobile industry to fall apart.

I get it. This organized schadenfreude goes back to the dawn of Obama’s presidency, when Rush Limbaugh, later joined by Senator Mitch McConnell, said their No. 1 goal was for the president to fail. A CNN poll in 2010 found 61 percent of Republicans hoping Obama would fail (versus only 27 percent among all Americans).

Wish granted, mission accomplished. Obama has failed — that is, if you judge by his tanking poll numbers. But does this collapse in approval have to mean that the last best chance for expanding health care for millions of Americans must fail as well?

Does this mean we throw in the towel, and return to a status quo in which insurance companies routinely cancel policies, deny health care to people with pre-existing conditions and have their own death panel treatment for patients who reach a cap in medical benefits?

Rooting for Failure – NYTimes.com

I Watched My Patients Die of Treatable Diseases Because They Were Poor | Alternet

 

There’s a popular myth that the uninsured—in Texas, that’s 25 percent of us—can always get medical care through emergency rooms. Ted Cruz has argued that it is “much cheaper to provide emergency care than it is to expand Medicaid,” and Rick Perry has claimed that Texans prefer the ER system. The myth is based on a 1986 federal law called the Emergency Medical Treatment and Labor Act (EMTALA), which states that hospitals with emergency rooms have to accept and stabilize patients who are in labor or who have an acute medical condition that threatens life or limb. That word “stabilize” is key: Hospital ERs don’t have to treat you. They just have to patch you up to the point where you’re not actively dying. Also, hospitals charge for ER care, and usually send patients to collections when they cannot pay.

My patient went to the ER, but didn’t get treatment. Although he was obviously sick, it wasn’t an emergency that threatened life or limb. He came back to St. Vincent’s, where I went through my routine: conversation, vital signs, physical exam. We laughed a lot, even though we both knew it was a bad situation.

One night, a friend called to say that my patient was in the hospital. He’d finally gotten so anemic that he couldn’t catch his breath, and the University of Texas Medical Branch (UTMB), where I am a student, took him in. My friend emailed me the results of his CT scans: There was cancer in his kidney, his liver and his lungs. It must have been spreading over the weeks that he’d been coming into St. Vincent’s.

I went to visit him that night. “There’s my doctor!” he called out when he saw me. I sat next to him, and he explained that he was waiting to call his sister until they told him whether or not the cancer was “bad.”

“It might be one of those real treatable kinds of cancers,” he said. I nodded uncomfortably. We talked for a while, and when I left he said, “Well now you know where I am, so you can come visit me.”

I never came back. I was too ashamed, and too early in my training to even recognize why I felt that way. After all, I had done everything I could—what did I have to feel ashamed of?

UTMB sent him to hospice, and he died at home a few months later. I read his obituary in the Galveston County Daily News.

I Watched My Patients Die of Treatable Diseases Because They Were Poor | Alternet

Opinion: Cancer survivor: Obamacare got me covered – CNN.com

 In January, for the first time since my diagnosis 36 years ago, I will have an individual health plan that offers quality coverage for me and my family. I will save $628 every month on premiums. Best of all — I wasn’t even asked if I’ve ever had cancer.

Opinion: Cancer survivor: Obamacare got me covered – CNN.com

In the Health Law, an Open Door for Entrepreneurs – NYTimes.com

 

“In terms of hiring, the health care expenses contribute a huge, huge component to your cost of operation,” Ms. Petrou says. So instead of bringing on full-time employees, she relied on contract workers.

She is looking forward to getting price information online from the Small Business Health Options Program, or SHOP, an exchange that was created by the new law. (Currently, business owners can obtain estimated SHOP prices online, but specific ones are only available by mail after filling out and mailing in a PDF downloaded from Healthcare.gov. Some states, including California, have their own SHOP exchanges, and their procedures vary.)

Ms. Petrou says the law could enable her to hire full-time employees, depending on the new costs of coverage. If so, she will either pay for a portion of the individual plans that her employees shop for on the exchange, or she may take advantage of tax credits and offer a small group plan. “We now have options to explore,” she says.

Some experts say this type of flexibility may have a big impact on the economy over all.

“Assuming we get the website working, it’s going to be the biggest step we’ve had in a long time in the U.S. in terms of changing the structure of the economy,” says Craig Garthwaite, assistant professor of management and strategy at Northwestern University’s Kellogg School of Management. Mr. Garthwaite is a co-author of one of two recent studies that conclude that the Affordable Care Act could spur entrepreneurship by easing job lock — where people stay in a job mainly for the health insurance.

In the Health Law, an Open Door for Entrepreneurs – NYTimes.com

Obamacare meets extra resistance in Oklahoma – Page 2 – Los Angeles Times

The cognitive dissonance should make these people’s heads explode, but I don’t think there’s enough cognition to create the dissonance.

In dozens of interviews here, many said they feared they would be forced to buy insurance they couldn’t afford. Some said they were told (erroneously) that insurance penalties would come out of their Social Security checks; others said they’d heard the law meant they’d soon have to travel several hundred miles to see a doctor.

"They say it’s affordable, but when you ain’t got no money, nothing’s affordable," said 55-year-old Paul Bush of Midwest City, who accompanied his sister to a clinic for care last week. While he supports efforts in Congress to kill the program — "Heck yeah," he said — he wasn’t happy about Fallin’s decision to reject the Medicaid expansion: "The state could really have used the money."

Bush’s sister, Teresa Springer, might have qualified for care under a Medicaid expansion, but she supported Fallin’s decision.

Springer, who has applied for disability assistance, said she worried that fines related to the healthcare law would cut into her disability checks at the same time that some Republicans in Congress were talking about cutting food stamps.

"That’s all I have," she said after a visit to the Mary Mahoney Memorial Health Center in Spencer, Okla. "I’m going to either pay my bills or not eat." The law, she added, "is hurting everybody."

Obamacare meets extra resistance in Oklahoma – Page 2 – Los Angeles Times

Obamacare and part-time jobs: The myth exploded (again) – latimes.com

 

Tuesday’s tepid brew of jobs data, delayed more than two weeks by the government shutdown, wasn’t worth waiting for. It shows an increase in total nonfarm employment by 148,000 in September over August, which is consistent with economic growth crawling along in second gear.

The report’s most notable nugget is the change in part-time work. Over the last month the number of workers in part-time jobs for economic reasons–slack demand, cutbacks in hours–has remained stable. Over the last year, however, it has fallen by 681,000. Those part-timers also constitute a smaller share of all workers–5.5% in September compared to 6% a year earlier.

That puts the lie to the popular conservative meme that Obamacare has transformed America’s workforce into part-timers. The idea is that employers wishing to evade the law’s requirement that they offer health insurance to employees working more than 30 hours a week will cut their hours to 29 or less. The shorthand about this provided by Sen. Ted Cruz (R-Texas), that one-stop shop for Obamacare disinformation, was "single parents who have been forced into part-time work."

Obamacare and part-time jobs: The myth exploded (again) – latimes.com